Shaping India’s Path to Inclusive Health Care

Why in News?

• World Health Day, observed annually on April 7, serves as a reminder of the importance of health equity, a fundamental human right as declared by the World Health Organization (WHO).
• Therefore, it is important to examine the theme of "My Health, My Right," exploring the challenges and solutions to achieving health equity in India, a nation grappling with diverse socioeconomic disparities in healthcare access and outcomes.

Health Equity and Its Significance

• Definition and Scope of Health Equity
  • Health equity, as defined by the WHO, is the principle that every individual should have the opportunity to achieve their highest level of health, regardless of their social, economic, or environmental circumstances.
  • This concept goes beyond mere access to healthcare services; it encompasses addressing the underlying determinants of health disparities, such as poverty, discrimination, and unequal distribution of resources.
• Recognition of Health Outcomes Based on Several Factors
  • One of the fundamental aspects of health equity is the recognition that health outcomes are shaped by a complex interplay of factors, including social, economic, and environmental determinants.
  • Individuals from disadvantaged socioeconomic backgrounds often face barriers to accessing healthcare services, including financial constraints, lack of transportation, and limited availability of healthcare facilities in their communities.
• Significance of Health Equity
  • Health equity is essential not only from a moral and ethical standpoint but also from a public health perspective.
  • Research has consistently shown that populations with greater levels of health equity tend to experience better overall health outcomes, including lower rates of morbidity and mortality, reduced healthcare costs, and increased life expectancy.
  • On the other hand, persistent health inequities can lead to societal instability, economic burden, and diminished human potential.

Health Equity Challenges in India

• Urban-Rural Disparities
  • India grapples with significant disparities in healthcare access and outcomes between urban and rural areas.
  • While urban centres often have better healthcare infrastructure and services, rural communities face numerous barriers, including limited access to healthcare facilities, shortage of healthcare professionals, and inadequate healthcare infrastructure.
  • As a result, residents of rural areas often have poorer health outcomes compared to their urban counterparts.
• Overcrowded Urban Slums
  • Urban slums in India represent pockets of extreme poverty and deprivation, characterised by overcrowding, poor sanitation, and limited access to clean water.
  • These conditions create fertile grounds for the spread of infectious diseases, leading to higher morbidity and mortality rates among slum dwellers.
  • Moreover, the lack of adequate healthcare facilities in slum areas further exacerbates health inequities, as residents struggle to access essential healthcare services.
• Socioeconomic and Caste Disparities
  • Marginalised groups, including Scheduled Castes, Scheduled Tribes, and economically disadvantaged populations, experience higher rates of morbidity and mortality due to limited access to healthcare services, lower health literacy, and social discrimination.
  • These disparities intersect with other social determinants of health, such as education, employment, and housing, further widening the gap in health outcomes.
• Burden of Non-Communicable Diseases (NCDs)
  • Non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, and cancer, pose a growing challenge to health equity in India.
  • While infectious diseases have traditionally been a major focus of public health efforts, NCDs now account for a significant proportion of the disease burden in the country.
  • However, access to preventive services and treatment for NCDs remains limited, particularly among marginalised populations, leading to disparities in health outcomes and exacerbating existing social and economic inequalities.
• Shortage of Healthcare Professionals
  • A critical shortage of doctors exacerbates these issues, with WHO data indicating only 0.8 doctors per 1,000 people, which is below the advised ratio.
  • Even though over 75% of health-care professionals work in metropolitan regions, which only account for 27% of the population, the shortage is particularly severe in rural areas.
  • As a result, residents of rural areas often lack access to primary healthcare services, leading to delayed diagnosis, inadequate treatment, and poorer health outcomes.
• Infrastructure and Resource Constraints
  • Inadequate healthcare infrastructure, limited funding, and resource constraints pose significant challenges to health equity in India.
  • Many public healthcare facilities lack essential equipment, medicines, and trained staff, hindering their ability to deliver quality healthcare services.
  • Moreover, the unequal distribution of healthcare resources between urban and rural areas further exacerbates disparities in access to healthcare.

Way Forward: Solutions and Initiatives to Address Health Equity in India

• Strengthening Primary Healthcare
  • One of the key strategies to address health equity in India is strengthening primary healthcare services, particularly in rural and underserved areas.
  • This includes improving the availability and accessibility of primary care facilities, enhancing the skills and capacity of frontline healthcare workers, and ensuring the provision of essential health services, including preventive care, maternal and child health services, and management of chronic diseases.
  • Initiatives such as the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM) aim to expand access to primary healthcare services and reduce disparities in healthcare access between urban and rural areas.
• Promoting Universal Health Coverage
  • Universal health coverage (UHC) is critical for ensuring that all individuals have access to essential healthcare services without financial hardship.
  • Initiatives such as Ayushman Bharat, India's flagship health insurance scheme, aim to provide financial protection to vulnerable populations by offering cashless coverage for hospitalisation expenses.
  • By expanding access to quality healthcare services and reducing out-of-pocket expenses, UHC can help address disparities in healthcare access and improve health outcomes for all citizens.
• Addressing Social Determinants of Health
  • Health equity cannot be achieved solely through healthcare interventions; it also requires addressing the underlying social determinants of health, such as poverty, education, housing, and employment.
  • Initiatives aimed at poverty alleviation, improving access to education and sanitation, and creating livelihood opportunities can have a significant impact on health outcomes and help reduce disparities in health status.
  • For example, programs like the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) provide employment opportunities to rural households, contributing to improved socioeconomic conditions and better health outcomes.
• Promoting Health Literacy
  • Raising health literacy is essential for empowering individuals to make informed health decisions and seek equitable care.
  • Integrating health education into existing healthcare programs can enhance public awareness and promote preventive healthcare practices.
• Strengthening Collaborations
  • Effective collaboration among governments, civil society, healthcare providers, and international organisations is crucial for addressing health inequities.
  • By leveraging their respective strengths and resources, these stakeholders can develop culturally sensitive health initiatives tailored to the unique needs of communities.

Conclusion

• Promoting health equity in India requires concerted efforts across multiple sectors and stakeholders.
• By addressing the socioeconomic determinants of health, strengthening healthcare infrastructure, and fostering collaborative partnerships, India can move towards a future where access to high-quality healthcare is a shared reality for all its citizens.

Achieving health equity is not merely a moral imperative but also a prerequisite for sustainable development and social progress. 

Q) What is Aushman Bharat Yojna?

Aushman Bharat Yojna, also known as the Pradhan Mantri Jan Arogya Yojna (PMJAY), is a flagship healthcare scheme launched by the Government of India in 2018. It aims to provide health insurance coverage to over 500 million economically vulnerable individuals and families in India.

Q) What are the key benefits of Aushman Bharat Yojna?

Aushman Bharat Yojna offers several benefits, including cashless access to healthcare services, coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation, provision for treatment of pre-existing diseases, and coverage of hospitalisation expenses such as room charges, medical tests, and surgical procedures. Additionally, the scheme promotes the use of technology for effective implementation and monitoring, ensuring transparency and accountability in healthcare delivery.

Source:The Hindu